The challenges of using Escherichia coli as a host in recombinant insulin production

Abstract

Diabetes mellitus is a metabolic disease characterised by elevation of blood glucose level which leads to serious damage to the blood vessels, eyes, heart, kidney, and nerves affecting about 830 million people worldwide. The most common diabetes is type 2 which usually happened in adults when the body becomes resistant to insulin, or the body does not produce enough insulin. Type 1 diabetes mellitus is dependent on insulin which required accessible and affordable insulin (Diabetes, 2025).

In Malaysia, the prevalence of diabetes mellitus (DM), depends on factors such as gender, age, and ethnicity, with women, the elderly, and the Indian community having the highest prevalence of DM. In the 103,063 participants that made up the study's sample, the combined prevalence of diabetes by gender in the population-based studies was 13.80% for men and 14.54% for women, while the combined prevalence of prediabetes was 11.40% for women and 10.98% for men (Akhtar et al., 2022). For age, from this study, it can be observed that the prevalence of diabetes showed a notable upward trend as people aged, rising from 3.16% in the 20–29 age group to 13.71% in the 30-45 age group, 25.66% in the 46–59 age group, and 33.45% in the 60 and older age group (Akhtar et al., 2022). Ethnicity and races can also affect the prevalence of DM. The subpopulation of Indian had the greatest prevalence of diabetes which is 25.10%, among all ethnic groups, followed by Malay with 15.25%, Chinese with 12.87%, Bumiputera with 8.62%, and others with 6.91%. The prevalence demands oral hypoglycaemic agents (OHAs) market size in Malaysia at USD282.22 million in 2025 with a CAGR of greater than 3% during forecast period (2025-2030). The drugs are mainly fall under the following segment: biguanides, alpha-glucosidase inhibitors, dopamine-d2 receptor agonists, sodium-glucose cotransport-2 (SGLT-2) inhibitor, dipeptidyl peptidase-4 (DPP-4) inhibitors, sulfonylureas, and meglitinides (Malaysia Oral Anti-Diabetic Drug Market Size | Mordor Intelligence, 2025).